Medical Insurance Verification / Prior Authorisation Specialist

Experience Required : Minimum 2 years

Industry : Healthcare / Sleep Medicine / DME

We are a high-volume Sleep Specialist office seeking a reliable, organized, and experienced Medical Insurance Verification & Prior Authorization Specialist to join our fast-paced team. This role is vital to our operations, supporting both our sleep studies and DME services. The ideal candidate will be comfortable multitasking and stepping into different roles as needed.

Key Responsibilities :

Verify insurance benefits and eligibility for sleep studies, DME, and related procedures.

Obtain prior authorizations efficiently and accurately.

Understand and explain co-pays, deductibles, and co-insurance to patients.

Work with various insurance plans including HMO and PPO.

Document and track authorizations in EMR systems and Excel.

Communicate clearly and professionally with patients and insurance companies.

Support front office and billing teams when needed.

Handle a high call volume with excellent phone etiquette and attention to detail.

Requirements :

Minimum 2 years of experience in medical insurance verification and prior authorization.

Strong knowledge of co-pays, deductibles, co-insurance, and insurance plan types.

Familiar with sleep studies and DME services (preferred but not required).

Ability to multitask, stay organized, and shift roles when necessary.

Excellent verbal and written communication skills.

Proficient in EMR systems and Microsoft Office (especially Excel).

Strong team player with a positive and proactive attitude.